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Clinical Medicine of Healthcare and Sustainability

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Epidemiology & Public Health".

Deadline for manuscript submissions: closed (31 December 2020) | Viewed by 21565

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Special Issue Editors

Prof. Dr. Teen-Hang Meen

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Guest Editor

Department of Electronic Engineering National Formosa University, Yunlin 632, Taiwan
Interests: IOT devices; photovoltaic devices; STEM education
Special Issues, Collections and Topics in MDPI journals

Prof. Dr. Fukuyama Yoshiyasu

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Guest Editor

Department of Pharmaceutical Sciences, Tokushima Bunri University, Nishihama, Yamashiro-cho, Tokushima 770-8514, Japan
Interests: neuronal cell differentiation and growth; research to find neurotrophic-factor-like substances from plants that help maintain survival; development of chemical reactions of palladium catalysts
Special Issues, Collections and Topics in MDPI journals

Prof. Dr. Kuan-Han Lee

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Guest Editor

Dean of the College of Pharmacy and Science, Chia Nan University of Pharmacy & Science, Tainan, Taiwan
Interests: medicinal chemistry; organic synthesis; computer-aided drug design
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The 2nd IEEE Eurasia Conference on Biomedical Engineering, Healthcare and Sustainability 2020 (IEEE ECBIOS 2020, http://www.ecbios.asia) will be held in Osaka, Japan, on May 29–31, 2020, and will provide a unified communication platform for researchers on various topics in Biomedical Engineering, Healthcare and Sustainability. Healthcare has recently been undergoing sector-wide transformation, thanks to advances in computing, networking technologies, big data, and artificial intelligence. Healthcare is not only changing from being reactive and hospital-centered to preventive and personalized, but is also changing from disease-focused to wellbeing-centered. Healthcare systems as well as fundamental medicine research are becoming smarter and more enabled in Biomedical Engineering. Furthermore, with cutting edge sensors and computer technologies, healthcare delivery could also yield better efficiency, higher quality, and lower costs.

This Special Issue will showcase selected papers presented at IEEE ECBIOS 2020 and other high-quality papers on the Clinical Medicine of Healthcare and Sustainability, providing a platform for presenting advances in healthcare/clinical practices and the study of direct observation of patients and general medical research. Potential topics include, but are not limited to:

Traumatology and Precise Surgical Techniques
Genomics, Proteomics, and Bioinformatics in Clinical Cancer Research
Epidemiology
Neurological and Psychiatric Disorders
Advanced Research in Dermatology and Venereology
Ophthalmology and Otolaryngology
Medical Imaging and Nuclear Medicine
Rehabilitation Medicine and Physiotherapy
Sports Medicine
Pediatric and Geriatric Emergency Care

Prof. Dr. Teen-Hang Meen
Prof. Dr. Fukuyama Yoshiyasu
Prof. Dr. Kuan-Han Lee
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

Genomics, proteomics, and bioinformatics in clinical cancer research
Epidemiology
Neurological and psychiatric disorders
Rehabilitation medicine and physiotherapy
Sports medicine
Pediatric and geriatric emergency care

Published Papers (7 papers)

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Research

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8 pages, 588 KiB

Open AccessArticle

Epidemiology of Posterior Cruciate Ligament Reconstructions in Italy: A 15-Year Study

by Umile Giuseppe Longo, Marco Viganò, Vincenzo Candela, Laura de Girolamo, Eleonora Cella, Gabriele Thiebat, Giuseppe Salvatore, Massimo Ciccozzi and Vincenzo Denaro

J. Clin. Med. 2021, 10(3), 499; https://doi.org/10.3390/jcm10030499 - 01 Feb 2021

Cited by 12 | Viewed by 2369

Abstract

Background: The posterior cruciate ligament (PCL) is an essential element in knee stability. PCL reconstructions represent an under-investigated topic in the literature due to the rarity of this type of knee injury. This study aims to investigate the incidence of PCL reconstructive surgeries in Italy, following their trend during a 15-year period. Methods: The National Hospital Discharge records (SDO) collected by the Italian Ministry of Health between January 2001 and October 2015 were analyzed. The database reports anonymous data comprising patients’ ages, genders, International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes for diagnosis and intervention, census regions, regions of hospitalization, lengths of hospitalization and types of reimbursement. Results: The overall incidence of PCL reconstructions in the Italian population during the study period was 0.46 surgeries per 100,000 inhabitants/year, ranging from 0.32 to 0.54. The median patient’s age was 30 years old, and the male:female ratio was 5.3. PCL lesions were isolated in 39.7% of patients, while anterior cruciate ligament injuries were the most frequently associated lesions (31.1%). Conclusions: The incidence of PCL reconstruction in Italy was low and stable during the study period. Young men are the category at the highest risk for these procedures. Given the paucity of epidemiological data on PCL reconstructions, this data may represent a reference for the current and foreseeable needs in PCL surgeries for countries sharing similar cultural context. Full article

(This article belongs to the Special Issue Clinical Medicine of Healthcare and Sustainability)

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20 pages, 3509 KiB

Open AccessArticle

Comparisons of the Nonlinear Relationship of Cerebral Blood Flow Response and Cerebral Vasomotor Reactivity to Carbon Dioxide under Hyperventilation between Postural Orthostatic Tachycardia Syndrome Patients and Healthy Subjects

by Shyan-Lung Lin, Shoou-Jeng Yeh, Ching-Kun Chen, Yu-Liang Hsu, Chih-En Kuo, Wei-Yu Chen and Cheng-Pu Hsieh

J. Clin. Med. 2020, 9(12), 4088; https://doi.org/10.3390/jcm9124088 - 18 Dec 2020

Cited by 2 | Viewed by 1722

Abstract

Postural orthostatic tachycardia syndrome (POTS) typically occurs in youths, and early accurate POTS diagnosis is challenging. A recent hypothesis suggests that upright cognitive impairment in POTS occurs because reduced cerebral blood flow velocity (CBFV) and cerebrovascular response to carbon dioxide (CO₂) are nonlinear during transient changes in end-tidal CO₂ (P_ETCO₂). This novel study aimed to reveal the interaction between cerebral autoregulation and ventilatory control in POTS patients by using tilt table and hyperventilation to alter the CO₂ tension between 10 and 30 mmHg. The cerebral blood flow velocity (CBFV), partial pressure of end-tidal carbon dioxide (P_ETCO₂), and other cardiopulmonary signals were recorded for POTS patients and two healthy groups including those aged >45 years (Healthy-Elder) and aged <45 years (Healthy-Youth) throughout the experiment. Two nonlinear regression functions, Models I and II, were applied to evaluate their CBFV-P_ETCO₂ relationship and cerebral vasomotor reactivity (CVMR). Among the estimated parameters, the curve-fitting Model I for CBFV and CVMR responses to CO₂ for POTS patients demonstrated an observable dissimilarity in CBFV_max (p = 0.011), mid-P_ETCO₂ (p = 0.013), and P_ETCO₂ range (p = 0.023) compared with those of Healthy-Youth and in CBFV_max (p = 0.015) and CVMR_max compared with those of Healthy-Elder. With curve-fitting Model II for POTS patients, the fit parameters of curvilinear (p = 0.036) and P_ETCO₂ level (p = 0.033) displayed significant difference in comparison with Healthy-Youth parameters; range of change (p = 0.042), P_ETCO₂ level, and CBFV_max also displayed a significant difference in comparison with Healthy-Elder parameters. The results of this study contribute toward developing an early accurate diagnosis of impaired CBFV responses to CO₂ for POTS patients. Full article

(This article belongs to the Special Issue Clinical Medicine of Healthcare and Sustainability)

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12 pages, 249 KiB

Open AccessArticle

Level of Palliative Care Complexity in Advanced Cancer Patients: A Multinomial Logistic Analysis

by Maria Isabel Carrasco-Zafra, Rafael Gómez-García, Ricardo Ocaña-Riola, Maria Luisa Martín-Roselló and Encarnación Blanco-Reina

J. Clin. Med. 2020, 9(6), 1960; https://doi.org/10.3390/jcm9061960 - 23 Jun 2020

Cited by 9 | Viewed by 3159

Abstract

The current treatment approach for patients in palliative care (PC) requires a health model based on shared and individualised care, according to the degree of complexity encountered. The aims of this study were to describe the levels of complexity that may be present, to determine their most prevalent elements and to identify factors that may be related to palliative complexity in advanced-stage cancer patients. An observational retrospective study was performed of patients attended to at the Cudeca Hospice. Socio-demographic and clinical data were compiled, together with information on the patients’ functional and performance status (according to the Palliative Performance Scale (PPS)). The level of complexity was determined by the Diagnostic Instrument of Complexity in Palliative Care (IDC-Pal©) and classified as highly complex, complex or non-complex. The impact of the independent variables on PC complexity was assessed by multinomial logistic regression analysis. Of the 501 patients studied, 44.8% presented a situation classed as highly complex and another 44% were considered complex. The highly complex items most frequently observed were the absence or insufficiency of family support and/or caregivers (24.3%) and the presence of difficult-to-control symptoms (17.3%). The complex item most frequently observed was an abrupt change in the level of functional autonomy (47.6%). The main factor related to the presence of high vs. non-complexity was that of performance status (odds ratio (OR) = 10.68, 95% confidence interval (CI) = 2.81–40.52, for PPS values < 40%). However, age was inversely related to high complexity. This study confirms the high level of complexity present in patients referred to a PC centre. Determining the factors related to this complexity could help physicians identify situations calling for timely referral for specialised PC, such as a low PPS score. Full article

(This article belongs to the Special Issue Clinical Medicine of Healthcare and Sustainability)

13 pages, 2588 KiB

Open AccessArticle

Chronic Gastritis Is Associated with a Decreased High-Density Lipid Level: Histological Features of Gastritis Based on the Updated Sydney System

by Dong-Hoon Kim, Byoung Kwan Son, Kyueng-Whan Min, Sang Kuk Han, Ji Ung Na, Pil Cho Choi, Hack-Lyoung Kim, Mi Jung Kwon, Young Ha Oh, Woon Yong Jung, Ji-Yong Moon, Sangmo Hong, Ki-Wook Oh and Young Seo Kim

J. Clin. Med. 2020, 9(6), 1856; https://doi.org/10.3390/jcm9061856 - 14 Jun 2020

Cited by 8 | Viewed by 4046

Abstract

Chronic gastritis could activate a systemic inflammatory response that could result in adverse lipid profiles. To determine the severity of chronic gastritis, Helicobacter pylori (HP), mononuclear cell (lymphocytes and plasma cells), and neutrophil scores were assessed on the basis of the updated Sydney system (USS), which is widely used for histological grading. The aim of this study was to assess the relationships between gastric histological features and lipid profile levels. This study included 15,322 males and 5929 females who underwent a health checkup and gastric biopsy at the Kangbuk Samsung Medical Center (KBSMC). We analyzed whether the HP, mononuclear cell, and neutrophil grades according to the USS were related to serum leukocyte count, unhealthy behaviors, and lipid profile levels. Gastritis with HP, neutrophils, or moderate to severe mononuclear cells was associated with an elevated serum leukocyte count. A high leukocyte count was related to increased low-density lipoproteins (LDL) and triglycerides/very-low-density lipoprotein (VLDL) and decreased high-density lipoproteins (HDL). In multivariate analyses, chronic gastritis with HP or moderate to severe mononuclear cells was significantly associated with decreased HDL in males, while mononuclear cells were significantly related to decreased HDL in females. Chronic gastritis was associated with an increased systemic inflammatory response, which was associated with unfavorable lipid profiles, especially low HDL levels. Full article

(This article belongs to the Special Issue Clinical Medicine of Healthcare and Sustainability)

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10 pages, 266 KiB

Open AccessArticle

Differences in Results and Related Factors between Hospital-At-Home Modalities in Catalonia: A Cross-Sectional Study

by Jorge Arias-de la Torre, Evangelia Anna María Zioga, Lizza Macorigh, Laura Muñoz, Oriol Estrada, Montse Mias, Maria-Dolors Estrada, Elisa Puigdomenech, Jose M. Valderas, Vicente Martín, Antonio J. Molina and Mireia Espallargues

J. Clin. Med. 2020, 9(5), 1461; https://doi.org/10.3390/jcm9051461 - 13 May 2020

Cited by 4 | Viewed by 3324

Abstract

Hospital-at-home (HaH) is a healthcare modality that provides active treatment by healthcare staff in the patient’s home for a condition that would otherwise require hospitalization. The aims were to describe the characteristics of different types of hospital-at-home (HaH), assess their results, and examine which factors could be related to these results. A cross-sectional study based on data from all 2014 HaH contacts from Catalonia was designed. The following HaH modalities were considered—admission avoidance (n = 7214; 75.1%) and early assisted discharge (n = 2387; 24.9%). The main outcome indicators were readmission, mortality, and length of stay (days). Multivariable models were fitted to assess the association between explanatory factors and outcomes. Hospital admission avoidance is a scheme in which, instead of being admitted to acute care hospitals, patients are directly treated in their own homes. Early assisted discharge is a scheme in which hospital in-care patients continue their treatment at home. In the hospital avoidance modality, there were 8.3% readmissions, 0.9% mortality, and a mean length of stay (SD) of 9.6 (10.6) days. In the early assisted discharge modality, these figures were 7.9%, 0.5%, and 9.8 (11.1), respectively. In both modalities, readmission and mean length of stay were related to comorbidity and type of hospital, and mortality with age. The results of HaH in Catalonia are similar to those observed in other contexts. The factors related to these results identified might help to improve the effectiveness and efficiency of the different HaH modalities. Full article

(This article belongs to the Special Issue Clinical Medicine of Healthcare and Sustainability)

11 pages, 857 KiB

Open AccessArticle

Hearing Loss and Risk of Overall, Injury-Related, and Cardiovascular Mortality: The Kangbuk Samsung Health Study

by Woncheol Lee, Yoosoo Chang, Hocheol Shin and Seungho Ryu

J. Clin. Med. 2020, 9(5), 1415; https://doi.org/10.3390/jcm9051415 - 10 May 2020

Cited by 15 | Viewed by 2768

Abstract

Hearing loss (HL) has been related to cardiovascular risk factors as well as prevalence of cardiovascular disease itself. We evaluated the association of HL with overall, injury-related, and cardiovascular mortality. A cohort study included 580,798 Korean adults (mean age: 39.7) who attended a screening exam between 2002 and 2016 with a follow-up of up to 17 years. HL was defined as a pure-tone average of thresholds at 0.5, 1.0, and 2.0 kHz ≥25 dB (decibels) in the better ear and further categorized into mild (25–<40 dB) and moderate-to-severe (≥40 dB). Overall and cause-specific mortality was ascertained through linkage to national death records. During median follow-up of 8.4 years, 6581 overall deaths, 977 cardiovascular deaths, and 1161 injury-related deaths were identified. Compared to participants with normal hearing, multivariable-adjusted hazard ratios (HRs) with 95% confidence intervals (95% CIs) for overall mortality among participants with mild and moderate-to-severe HL were 1.13 (1.05–1.21) and 1.30 (1.16–1.46), respectively. Corresponding HRs (95% CIs) for cardiovascular mortality were 1.32 (1.10–1.58) and 1.53 (1.16–2.01), respectively, and corresponding HRs (95% CIs) for injury-related mortality were 1.03 (0.81–1.31) and 1.64 (1.13–2.36), respectively. In this large cohort, HL was positively and independently associated with overall, cardiovascular, and injury-related mortality. A significantly elevated risk of cardiovascular mortality started from mild HL. Full article

(This article belongs to the Special Issue Clinical Medicine of Healthcare and Sustainability)

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Review

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15 pages, 1686 KiB

Open AccessReview

Visual Verticality Perception in Spinal Diseases: A Systematic Review and Meta-Analysis

by Esteban Obrero-Gaitán, Francisco Molina, Rafael Del-Pino-Casado, Alfonso Javier Ibáñez-Vera, Daniel Rodríguez-Almagro and Rafael Lomas-Vega

J. Clin. Med. 2020, 9(6), 1725; https://doi.org/10.3390/jcm9061725 - 03 Jun 2020

Cited by 3 | Viewed by 3175

Abstract

Patients diagnosed with traumatic or non-traumatic spinal pain and idiopathic scoliosis frequently suffer from imbalance. The evaluation of the perception of verticality by means of visual tests emerges as a quick and easy tool for clinical management of the balance disorders. Several studies have assessed the visual perception of verticality in spinal diseases obtaining controversial results. The aim of our study is to analyze the perception of visual verticality in subjects with several spinal diseases in comparison with healthy subjects. A meta-analysis was carried out. PubMed MEDLINE, Scopus, WoS, CINAHL, and SciELO databases were searched until January 2020. The standardized mean difference (SMD) was calculated to analyze differences between patients and healthy controls. Fifteen studies with a total of 2052 patients were included. In comparison with healthy subjects, a misperception of verticality was found in patients with spinal pain when the perception of the verticality was assessed with the rod and frame test (SMD = 0.339; 95% confidence interval (CI) = 0.181, 0.497; p < 0.001). It seems that the perception of visual verticality is not altered in patients with idiopathic scoliosis (p = 0.294). The present meta-analysis shows a misperception of visual verticality only in patients with spinal pain. Full article

(This article belongs to the Special Issue Clinical Medicine of Healthcare and Sustainability)

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